回旋法治疗锁骨中段移位骨折  

Treatment of displaced midshaft clavicle fracture with convolution method

作　　者：刘发平[1] 胡湘洪[1] 王亮[1] 宫启琳 周雄儿[1] 魏明[1] 甘国清 占泽刚 LIU Fa-ping;HU Xiang-hong;WANG Liang;GONG Qi-lin;ZHOU Xiong-er;WEI Ming;GAN Guo-qing;ZHAN Ze-gang(Department of Orthopaedics,Hongdu Hospital of TCM of Nanchang,Nanchang 330008,Jiangxi,China)

机构地区：[1]南昌市洪都中医院骨科,江西南昌330008

出　　处：《中国骨伤》2020年第6期545-548,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨回旋法整复锁骨中段移位骨折的临床疗效。方法:2018年1月至2019年7月就诊的锁骨中段移位骨折患者32例,男21例,女11例;年龄18~65岁,中位数41.5岁;左侧19例,右侧13例;就诊时间30 min^5 d。应用回旋法配合反复推旋患侧上肢复位后锁骨带外固定治疗,观察术后骨折复位、愈合情况及肩关节功能恢复情况。结果:术后通过摄X线片进行骨折复位评定,优7例,良20例,可5例,差0例。32例均获随访,随访时间14~18周,Neer肩关节功能总评分(89.75±6.88)分,其中疼痛(32.66±2.54)分,功能(26.44±2.91)分,活动度(22.38±2.06)分,解剖(8.43±0.84)分;优17例,良14例,可1例,取得满意疗效。结论:回旋法配合反复推旋患侧上肢可良好复位锁骨中段移位骨折,复位后行绷带及锁骨带外固定,功能锻炼贯穿治疗全程,肩关节功能恢复良好,取得满意的治疗效果。Objective:To explore the clinical effects of convolution method in treating displaced midshaft clavicle fracture.Methods:From January 2018 to July 2019,32 patients(21 males and 11 females)with displaced midshaft clavicle fracture were treated,ranging in age from 18 to 65 years old,with a median age of 41.5 years old.Nineteen patients had fractures on the left side and 13 patients had fractures on the right side.The duration from injury to treatment ranged from 30 minutes to5 days.The patients were treated with convolution method and repeated push and rotation of the affected upper limb,followed by external fixation of clavicle band.The reduction and healing of the fracture and the functional recovery of shoulder joint were observed.Results:After operation,fracture reduction was evaluated by X-ray film.Seven patients had an excellent result,20 good and 5 fair.All the patients were followed up,and the duration ranged from 14 to 18 weeks.The mean Neer score was89.75±6.88,which included pain score of 32.66±2.54,functional score of 26.44±2.91,range of motion score of 22.38±2.06,and anatomy score of 8.43±0.84;17 patients receive an excellent result,14 good and 1 fair.Conclusion:The rotation method combined with the repeated pushing and rotating of the upper limb of the affected side can well reduce the displaced fracture of the middle clavicle.Bandage and clavicle band can be performed after reduction.Functional exercise runs through the whole course of treatment.Functional recovery of shoulder joint is good and satisfactory therapeutic effect is achieved.

关 键 词：锁骨 骨折 正骨手法 

分 类 号：R683[医药卫生—骨科学]